METHODS: We quantified the directed information flow using partial directed coherence (PDC) and the topological networks by graph theory measures at four frequency bands (delta, theta, alpha, and beta). The PDC assesses the causal interactions between neuronal units of the brain network. Besides, the graph theory of the complex network identifies the topological structure of the network. Resting-state electroencephalogram (EEG) data were recorded for 66 patients with different severities of SAD (22 severe, 22 moderate, and 22 mild) and 22 demographically matched healthy controls (HC).
RESULTS: PDC results have found significant differences between SAD groups and HCs in theta and alpha frequency bands (p < 0.05). Severe and moderate SAD groups have shown greater enhanced information flow than mild and HC groups in all frequency bands. Furthermore, the PDC and graph theory features have been used to discriminate three classes of SAD from HCs using several machine learning classifiers. In comparison to the features obtained by PDC, graph theory network features combined with PDC have achieved maximum classification performance with accuracy (92.78%), sensitivity (95.25%), and specificity (94.12%) using Support Vector Machine (SVM).
DISCUSSION: Based on the results, it can be concluded that the combination of graph theory features and PDC values may be considered an effective tool for SAD identification. Our outcomes may provide new insights into developing biomarkers for SAD diagnosis based on topological brain networks and machine learning algorithms.
MATERIALS AND METHODS: We searched PubMed and Scopus electronic databases to identify original studies reporting toxicity outcomes following PBT of primary NPC. Quality assessment was performed using NIH's Quality Assessment Tool. Reports were extracted for information on demographics, main results, and clinical and dose factors correlates. Meta-analysis was performed using the random-effects model.
RESULTS: Twelve studies were selected (six using mixed particle-photon beams, five performed comparisons to photon-based therapy). The pooled event rates for acute grade ≥2 toxicities mucositis, dermatitis, xerostomia weight loss are 46% (95% confidence interval [95% CI]-29%-64%, I2 = 87%), 47% (95% CI-28%-67%, I2 = 87%), 16% (95% CI-9%-29%, I2 = 76%), and 36% (95% CI-27%-47%, I2 = 45%), respectively. Only one late endpoint (xerostomia grade ≥2) has sufficient data for analysis with pooled event rate of 9% (95% CI-3%-29%, I2 = 77%), lower than intensity-modulated radiotherapy 27% (95% CI-10%-54%, I2 = 95%). For most endpoints with significant differences between the PBT and photon-based therapies, PBT resulted in better outcomes. In two studies where dose distribution was studied, doses to the organs at risk were independent risk factors for toxicities.
CONCLUSION: PBT may reduce the risk of acute toxicities for patients treated for primary NPC, likely due to dose reduction to critical structures. The pooled event rate for toxicities derived in this study can be a guide for patient counseling.
Materials and methods: Eighty-four patients were randomly divided into two groups receiving either study drug infusion. Anxiety
score, level of sedation using the Bispectral Index and Observer’s Assessment of Alertness and Sedation, hemodynamic stability, and
overall patient’s feedback on anxiolysis were assessed.
Results: Both groups showed a significant drop in mean anxiety score at 10 and 30 min after starting surgery. Difference in median
anxiety scores showed a significant reduction in anxiety score at the end of the surgery in the dexmedetomidine group compared to the
propofol group. Dexmedetomidine and propofol showed a significant drop in mean arterial pressure in the first 30 min and first 10 min
respectively. Both drugs demonstrated a significant drop in heart rate in the first 20 min from baseline after starting the drug infusion.
Patients in the dexmedetomidine group (76.20%) expressed statistically excellent feedback on anxiolysis compared to patients in the
propofol group (45.20%).
Conclusion: Dexmedetomidine infusion was found to significantly reduce anxiety levels at the end of surgery compared to propofol
during regional anesthesia.
METHOD: Cross-sectional study on 68 parents of Malaysian children aged 2-18 years with TSC. QOL was assessed using proxy-report Paediatric Quality of Life Inventory (PedsQL) V.4.0, and scores compared with those from a previous cohort of healthy children. Parents also completed questionnaires on child behaviour (child behaviour checklist (CBCL)) and parenting stress (parenting stress index-short form). Multiple regression analysis was used to determine sociodemographic, medical, parenting stress and behavioural factors that impacted on QOL.
RESULTS: The mean proxy-report PedsQL V.4.0 total scale score, physical health summary score and psychosocial health summary score of the patients were 60.6 (SD 20.11), 65.9 (SD 28.05) and 57.8 (SD 19.48), respectively. Compared with healthy children, TSC patients had significantly lower mean PedsQL V.4.0 total scale, physical health and psychosocial health summary scores (mean difference (95% CI): 24 (18-29), 20 (12-27) and 26 (21-31) respectively). Lower total scale scores were associated with clinically significant CBCL internalising behaviour scores, age 8-18 years and Chinese ethnicity. Lower psychosocial health summary scale scores were associated with clinically significant CBCL internalising behaviour scores, Chinese ethnicity or >1 antiepileptic drug (AED).
CONCLUSION: Parents of children with TSC reported lower PedsQL V.4.0 QOL scores in all domains, with psychosocial health most affected. Older children, those with internalising behaviour problems, of Chinese ethnicity or on >1 AED was at higher risk of lower QOL. Clinicians need to be vigilant of QOL needs among children with TSC particularly with these additional risk factors.